Television-Related Head Injuries in Children A Secondary Analysis of a Large Cohort Study of Head-Injured Children in the Pediatric Emergency Care Applied Research Network
Television-Related Head Injuries in Children A Secondary Analysis of a Large Cohort Study of Head-Injured Children in the Pediatric Emergency Care Applied Research Network
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DOI：
10.1097/pec.0000000000000605
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发表时间：
2022-07-01
影响因子：
1.4
通讯作者：
Kuppermann, Nathan
中科院分区：
文献类型：
--
作者：
Lichenstein, Richard;Monroe, David;Kuppermann, Nathan
目的本研究的目的是描述电视翻倒后钝性头部创伤儿童的流行病学、颅脑计算机断层扫描（CT）结果和临床结果。方法我们对2004年6月至2006年9月在儿科急诊应用研究网络的25个急诊科（ed）前瞻性评估的18岁以下钝性头部创伤儿童进行了二次分析。其中包括因电视坠落而受伤的儿童。如果损伤发生在ED评估前24小时以上，或者在评估前进行了神经影像学检查，则排除患者。收集的数据包括年龄、种族、性别、头颅CT表现和临床结果。临床上重要的创伤性脑损伤（ciTBIs）定义为CT显示与TBI相关的TBI死亡、神经外科手术、TBI插管超过24小时或颅脑损伤住院2晚或更长时间。结果共有43,904名儿童参加了初步研究，其中218名儿童（0.5%；95%可信区间[CI]， 0.4%至0.6%）被摔倒的电视机击中。218例患者的年龄中位数（四分位数间距）为3.1（1.9-4.9）岁。218例患者中有75例（34%）接受了CT扫描。75例ED CT患者中有10例（13.3%;95% CI， 6.6%至23.2%）在颅脑CT扫描中有创伤性发现。6例患者符合ciTBI标准。其中3名患者死亡。6例ciTBIs患者均小于5岁。结论：电视翻倒可引起儿童颅脑损伤，包括死亡，最严重的损伤发生在5岁或以下的儿童。这些伤害可以通过简单的预防措施来预防，例如用带子固定电视机。
Objective The objective of the study was to describe the epidemiology, cranial computed tomography (CT) findings, and clinical outcomes of children with blunt head trauma after television tip-over injuries. Methods We performed a secondary analysis of children younger than 18 years prospectively evaluated for blunt head trauma at 25 emergency departments (EDs) in the Pediatric Emergency Care Applied Research Network from June 2004 to September 2006. Children injured from falling televisions were included. Patients were excluded if injuries occurred more than 24 hours before ED evaluation or if neuroimaging was obtained before evaluation. Data collected included age, race, sex, cranial CT findings, and clinical outcomes. Clinically important traumatic brain injuries (ciTBIs) were defined as death from TBI, neurosurgery, intubation for more than 24 hours for the TBI, or hospital admission of 2 nights or more for the head injury, in association with TBI on CT. Results A total of 43,904 children were enrolled into the primary study and 218 (0.5%; 95% confidence interval [CI], 0.4% to 0.6%) were struck by falling televisions. The median (interquartile range) age of the 218 patients was 3.1 (1.9-4.9) years. Seventy-five (34%) of the 218 underwent CT scanning. Ten (13.3%; 95% CI, 6.6% to 23.2%) of the 75 patients with an ED CT had traumatic findings on cranial CT scan. Six patients met the criteria for ciTBI. Three of these patients died. All 6 patients with ciTBIs were younger than 5 years. Conclusions Television tip-overs may cause ciTBIs in children, including death, and the most severe injuries occur in children 5 years or younger. These injuries may be preventable by simple preventive measures such as anchoring television sets with straps.